Table 1.
Types and characteristics of right ventricular mechanical circulatory support devices.
| Impella RP | Percutaneous RA to PA RVAD |
Surgical RA to PA RVAD |
VA-ECMO | |
|---|---|---|---|---|
| Flow (L/min) | ~4.0–5.0 L/min | ~4–5 L/min | ~4–7 L/min | ~4–6 L/min |
| Mechanism of action | Transvalvular micro-axial pump | Centrifugal cardiac bypass | Centrifugal cardiac bypass | Centrifugal cardiopulmonary bypass |
| Access site | Femoral or Jugular Vein | Jugular Vein | Surgical RA and PA access | Femoral/Axillary Artery Femoral/Jugular Vein |
| Sheath size | 23F | 29 Fr 31 Fr |
Drainage 32–36 Fr Return 32–36 Fr |
Drainage—21–29 Fr Return—15–19 Fr |
| Pre-capillary PA Flow | ↑ | ↑ | ↑ | ↓ |
| Advantages | Venous only access | Venous only access Ability to oxygenate |
Ability to oxygenate | Biventricular support, Ability to oxygenation |
| Disadvantages | Unable to oxygenate | Risk of SVC Syndrome | Surgical access required | Requires large bore arterial access, Increased afterload can affect LV function |
LV, left ventricular; PA, pulmonary artery; RA, right atrial; RVAD, right ventricular; SVC, superior vena cava; VA-ECMO, venoarterial extracorporeal membrane oxygenation; ↑, increase; ↓, decrease.